| NPI | 1154712792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5007635) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN CNP 3660) |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2023-05-02 |